| NPI | 1588043442 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71005604A)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3010621)  | 
| Enumeration Date | 2015-05-26 | 
| Last Update Date | 2016-09-06 |